Alarm bells over mushrooming mental health clinics in Kerala

Lack of laws to regulate and monitor the functioning of clinics and virtual consultants has led to credibility issues, misdiagnosis of mental conditions, and delays in providing treatment
Representational image
Representational image

KOCHI: In the post-Covid era, social media has played a huge role in raising awareness on the significance of mental health, therapy centres, virtual counselling and consultations. With the increased popularity and acceptance, the state has been witnessing a rise in the number of private mental health clinics.

However, a lack of legislation to regulate and monitor the functioning of these clinics and virtual consultants has led to credibility issues, misdiagnosis of mental conditions, and delays in providing treatment, experts pointed out.

“Wrong people giving counselling to people lead to tragic events,” said senior psychiatrist C J John, citing the instance of a person who attempted suicide and later consulted him. “He was suffering from depressive disorder, which required medication, and was taking advice from a former police officer. These pieces of advice did not help him, leading to the suicide attempt,” Dr John said.

Many unscientific practices are entering the field of psychology because of the notion that anyone can practice counselling, pointed out Dr Arun B Nair.

“We have seen some religious leaders counselling and using spirituality in this field. Unscientific interventions can even lead to the spread of malpractices, pseudoscience, and pseudo-beliefs,” he said.

According to experts, counselling is not everyone’s cup of tea and a degree or post-graduation in psychology does not qualify anyone for the job. Rather, proper training is imperative. “Only those with some knowledge of psychiatry and neurological disorders can understand if the individual requires medication or psychological therapy. Awareness on psychiatric and brain disorders that can come with psychiatric symptoms is important,” Dr John said.

Counselling requires confidentiality and technique, and importantly, the person has to adhere to training under the supervision of qualified and senior practitioners, he added.

“A poorly trained person counselling a patient may fail to diagnose the condition, or even misdiagnose, thereby delaying treatment and worsening the condition,” said Dr Dhanya Chandran, head of the department of psychology at Amrita Hospital, Kochi.

Sometimes, brain disorders can also be projected through psychiatric symptoms, Dr Arun said. “A counsellor needs to have the capability to understand and diagnose such issues,” he pointed out.

There is also the issue of self-styled counsellors charging a huge fee after giving some random advice, Dr Dhanya said.

“Counsellors and therapists get huge amounts as fees. Somewhere around Rs 500 for a one-hour session. It is an income source for several people,” she said.

Experts demand that registration and licensing norms similar to those issued by the Rehabilitation Council of India for rehabilitation professionals be brought in for counselling centres as well.

An official with the directorate of health services (mental health) said that regulations for behavioural health science professionals are included in the Allied and Healthcare Professionals Act of 2021.

“The Act directs state governments to come up with a regulatory body for professionals and it will come into force in the state once the Act is implemented at the national level,” the official said.

“Licensing should be made mandatory before establishing a counselling clinic. Such clinics should be registered with the local bodies,” Dr John stressed.

The Mental Health Care Act 2017 has made it mandatory for mental health establishments to have registration and licence. “The state has established a Mental Health Authority based on the Act. The Act has specified the qualifications required for rehabilitation professionals. But counselling is not covered under it,” Dr Arun said, adding that awareness need to be spread on the qualifications.

“Often, people with mental health issues approach life coaches, trainers, and mind power trainers who may be qualified or trained in psychology. They can only give motivational speeches and train people to enhance business,” he said.

Writing down the qualifications and degrees on a name board should be made mandatory to prevent exploitation of patients, demanded Dr John.

Dr Dhanya wanted the government to take the initiative to appoint more trained counsellors at government establishments.

“If government hospitals have enough qualified counsellors, people won’t look for a private clinic,” she said. Dr John, too, stressed that the issue can be addressed with the installation of proper facilities at government hospitals.

“We have plenty of psychiatrists. Around 50 or 60 students pass out every year with an MD in Psychiatry from the government medical colleges in our state,” he said.

Who is a clinical psychologist?

A person who has acquired an MPhil in medical and social psychology after an MA or MSc in psychology. They are professionally capable of counselling people.

Who can prescribe medicines?

A psychiatrist who has completed MD in psychiatry after completing MBBS.

‘Govt should step in’

Experts said appointing more trained counsellors at govertnment establishments are important to tackle the issue.

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